Anxiety: Difference between revisions
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[[Cognitive behavioral therapy]] may help anxiety.<ref name="pmid20483968">{{cite journal| author=Roy-Byrne P, Craske MG, Sullivan G, Rose RD, Edlund MJ, Lang AJ et al.| title=Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. | journal=JAMA | year= 2010 | volume= 303 | issue= 19 | pages= 1921-8 | pmid=20483968 | [[Cognitive behavioral therapy]] may help anxiety.<ref name="pmid20483968">{{cite journal| author=Roy-Byrne P, Craske MG, Sullivan G, Rose RD, Edlund MJ, Lang AJ et al.| title=Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial. | journal=JAMA | year= 2010 | volume= 303 | issue= 19 | pages= 1921-8 | pmid=20483968 | ||
| url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20483968 | doi=10.1001/jama.2010.608 }} </ref> | | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=clinical.uthscsa.edu/cite&retmode=ref&cmd=prlinks&id=20483968 | doi=10.1001/jama.2010.608 }} </ref> | ||
===Monitoring the response to treatment=== | |||
The Daily Assessment of Symptoms - Anxiety (DAS-A) scale can help.<ref name="pmid18061206">{{cite journal| author=Morlock RJ, Williams VS, Cappelleri JC, Harness J, Fehnel SE, Endicott J et al.| title=Development and evaluation of the Daily Assessment of Symptoms - Anxiety (DAS-A) scale to evaluate onset of symptom relief in patients with generalized anxiety disorder. | journal=J Psychiatr Res | year= 2008 | volume= 42 | issue= 12 | pages= 1024-36 | pmid=18061206 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18061206 | doi=10.1016/j.jpsychires.2007.09.005 }} </ref> | |||
==References== | ==References== | ||
Revision as of 08:31, 14 October 2010
Anxiety is a physiological state marked by demonstrable changes in cognitive, somatic, emotional, and behavioral components. [1] These changes combine to create the sensations typically recognized as fear, apprehension, or worry. Anxiety is also often accompanied by physical sensations such as heart palpitations, nausea, chest pain, shortness of breath, stomach aches, or headache.
Cognitive changes point to an expectation of both present and diffuse danger. Somatically, the body prepares the organism to deal with a perceived threat; blood pressure and heart rate increase, perspiration and bloodflow to the major muscle groups increases, while immune and digestive functions are inhibited. External somatic indicators may present as pale skin, sweating, trembling, and/or pupillary dilation. Emotionally, anxiety induces a sense of dread or panic, and behavior directed at escaping or avoiding the source of anxiety may arise, as the anxiety reaction is an important survival mechanism.
Neurological considerations
Neurological systems that underlie anxiety include the amygdala and hippocampus. [2]. When confronted with unpleasant and potentially harmful stimuli, such as foul odors or tastes, PET-scans show increased bloodflow through the amygdala, while participants reported moderate, but measurable, anxiety. This indicates that anxiety may be a protective mechanism designed to prevent the organism from engaging in potentially harmful behaviors. [3] [4]
Diagnosis
The Kessler-6 scale may help diagnose.[5] At a cutoff of 13 or more points, the accuracy is:
- Sensitivity 36%
- Specificity 96%
Treatment
Exercise may reduce anxiety.[6]
Cognitive behavioral therapy may help anxiety.[7]
Monitoring the response to treatment
The Daily Assessment of Symptoms - Anxiety (DAS-A) scale can help.[8]
References
- ↑ Seligman, M.E.P., Walker, E.F. & Rosenhan, D.L. (2001). Abnormal psychology, (4th ed.) New York: W.W. Norton & Company, Inc.
- ↑ Rosen, J.B. & Schulkin, J. (1998): "From normal fear to pathological anxiety". Psychological Review. 105(2); 325-350.
- ↑ Zald, D.H. & Pardo, J.V. (1997). "Emotion, olfaction, and the human amygdala: amygdala activation during aversive olfactory stimulation." Proc Nat'l Acad Sci USA. 94(8), 4119-24.
- ↑ Zald, D.H., Hagen, M.C. & Pardo, J.V. (2002). "Neural correlates of tasting concentrated quinine and sugar solutions". J. Neurophysiol. 87(2), 1068-75.
- ↑ Kessler RC, Barker PR, Colpe LJ, Epstein JF, Gfroerer JC, Hiripi E et al. (2003). "Screening for serious mental illness in the general population.". Arch Gen Psychiatry 60 (2): 184-9. PMID 12578436.
- ↑ Herring MP, O'Connor PJ, Dishman RK (2010). "The effect of exercise training on anxiety symptoms among patients: a systematic review.". Arch Intern Med 170 (4): 321-31. DOI:10.1001/archinternmed.2009.530. PMID 20177034. Research Blogging.
- ↑ Roy-Byrne P, Craske MG, Sullivan G, Rose RD, Edlund MJ, Lang AJ et al. (2010). "Delivery of evidence-based treatment for multiple anxiety disorders in primary care: a randomized controlled trial.". JAMA 303 (19): 1921-8. DOI:10.1001/jama.2010.608. PMID 20483968. Research Blogging.
- ↑ Morlock RJ, Williams VS, Cappelleri JC, Harness J, Fehnel SE, Endicott J et al. (2008). "Development and evaluation of the Daily Assessment of Symptoms - Anxiety (DAS-A) scale to evaluate onset of symptom relief in patients with generalized anxiety disorder.". J Psychiatr Res 42 (12): 1024-36. DOI:10.1016/j.jpsychires.2007.09.005. PMID 18061206. Research Blogging.